Big Pharma continues to face the impact of competitive pressures, fluctuating currencies, the patent cliff, and pipeline surprises, all of which were reflected in financial results last year. Payers around the world are demanding lower cost drugs and increased access to medicines, while stakeholders look for higher returns on their investment.

Mergers and acquisitions, particularly those involving an offshore partner, continue to be seen, both as an easier way to augment a pipeline and as a tax-saving strategy, even though Pfizer’s $119-billion bid for AstraZeneca this Spring was rebuffed and Shire has also rejected AbbVie’s offers this Summer.

Divestments and increased focus on core markets were the themes last year, and we can continue to see them play out in the future. Both Novartis and Pfizer unloaded their animal health care businesses to focus on human therapeutics.

Companies are investing in developing economies and in biopharma, and forming strategic alliances, often with competitors, to achieve their goals. Exemplifying the trend was April’s business swap between Novartis and GSK, in which the companies traded vaccines and oncology businesses, and also built a new jointly owned consumer healthcare venture.

Novartis came in as number one, because its generics and vaccine manufacturing business totals were included, for parity with other manufacturers where these businesses were considered in the total. Clearly, biopharmaceutical products play an increasingly pivotal role in Big Pharma’s drug pipelines. For example, Pfizer, which narrowly trailed Novartis as player Number Two this year, reports that biopharmaceuticals contributed 93% of its total revenues last year (94% of that figure in 2012 and 95% in 2011).

Generics are becoming increasingly important, and, even before clear and harmonized global regulations take shape, companies are developing biosimilars pipelines. There is also a trend to investing in over-the-counter (OTC) markets, as more of yesteryear’s blockbusters are expected to be available directly to the consumer in the near future.

In response to these changing realities, we have expanded our list slightly this year, to include pharma and biopharma companies, consumer healthcare divisions, and generics firms.Here is a quick look at key financial results. Some figures reported last year were adjusted in this year’s annual reports. This report is a very broad brush stroke view of trends, news and strategies based on developments this and last year. We hope that you find it useful.

Top 25 Pharma and Biopharma Companies (Based on 2013 Sales, in $U.S. Millions)